Generalized Anxiety Disorder

GENERALIZED ANXIETY DISORDER

In common parlance the term "anxiety" is often used improperly, referring to general conditions of apprehension, nervousness and stress, so common in everyday life, that have nothing to do with the psychiatric disorder true and right.

The pathological anxiety is not a simple transitional discomfort, but an abnormal reaction that interferes seriously with the psycho-intellectual performance, preventing to fix your mind on issues and specific situations and process them, limiting the ability to do usual activities.

The generalized anxiety disorder does not necessarily occurs in response to external stimuli, but stressful events or a generally unfavorable environment can unmask or aggravates the demonstrations. Just as the Depression, the source of the anxiety disorder is linked to the altered functioning of certain brain circuits, not yet fully known, but at least in part involve the system of serotonin and norepinephrine.

YOU CAN ALSO READ ABOUT THE REMEDIES TO DEPRESSION

The anxiety disorder can occur at any time of life, often at a very critical transition periods or when you are faced with difficult choices. Most likely to suffer are women (affected twice more often than men), children and the elderly (especially with chronic diseases).

Factors that increase the chance of developing an anxiety disorder

Ø  Being women.

Ø  He has had traumatic experiences or have witnessed dramatic events in childhood.

Ø  Suffer from chronic diseases (in particular, cardiac, respiratory, digestive and metabolic) or have experienced a serious pathology (for example, a tumor).

·         This is called "Anxiety disorder due to another medical condition”.

Ø  You have been exposed to a source of intense acute stress or stress more modest, but repeated / protracted.

Ø  Have a psychological profile characterized by low adaptability to external stimuli and a spontaneous tendency to nervousness and worry.

Ø  Predisposition genetically based.

Ø  Intake of substances (alcohol, drugs, drugs, caffeine, nicotine, herbal extracts etc.) That tend to worsen the stress response and increase the tendency to anxiety.

·         This is called “Anxiety disorder induced by substances or drugs”.

Symptoms and diagnosis

Unlike in the case of depression, diagnosis of generalized anxiety disorder is quite simple because the symptoms are easily recognizable and discomfort experienced leads patients to seek medical attention relatively quickly. In addition to psychological symptoms , such as agitation and irritability, anxiety syndrome is associated generally to insomnia, appetite changes and a series of physical manifestations characteristics (rapid heart rate, difficulty breathing, increased thirst, need to move continuously, repetitive gestures etc.) that can reduce the quality of life significantly.

In the presence of manifestations of this kind, for a first general test, one can refer to the family doctor, but to get a correct diagnosis of anxiety disorder, precisely define the severity and find the most appropriate treatment strategy, it is advisable to consult a specialist.

Psychological and physical signs and symptoms of anxiety

Ø  Soreness and muscle contractures, a tendency to tighten their teeth during the day (grinding) and during the night (bruxism), trembling voice.

Ø  Ringing in the ears, blurred vision, flushing, localized pain with no obvious organic cause.

Ø  Tachycardia, palpitations, pain in the center of the chest, pressure drops, irregular pulse.

Ø  Sense of constriction and tightness in the chest, difficulty breathing, feeling of suffocation.

Ø  Increased urinary frequency, menstrual disorders and sexual desire.

Ø  Difficulty swallowing, indigestion, lack of appetite, nausea, vomiting, diarrhea.

Ø  Headache, dizziness, increased sweating, flushing or paleness, decreased salivation.

Ø  Concern constant or recurrent, unjustified or for trivial reasons, pessimism.

Ø  Irritability, inability to relax, hypersensitivity to stimuli and thrills, tearfulness, specific phobias.

Ø  Insomnia with difficulty falling asleep or sleep interrupted by nightmares, problems with concentration, reduced storage capacity.

In order to issue a diagnosis of generalized anxiety disorder, adults must be present at least three psychophysical symptoms among those listed in addition to anxiety and persistent concern and not commensurate with the actual severity of the events or without triggers. The set of events must be present for at least six months, for much of the time. In children, it takes only one additional physical and psychological symptoms and the duration of the events necessary for the diagnosis may be less.

Treatment of generalized anxiety disorder

There are many ways to combat generalized anxiety disorder: relaxation techniques , medication and psychotherapy . The medical doctor choose the most suitable in each case, possibly combining them, in relation to the severity and duration of the disturbances, the characteristics and age of the patient, to his willingness to engage in treatment and expectations with respect to clinical outcomes.

Relaxation techniques

Mild forms of anxiety and stress can be alleviated through relaxation techniques more or less specific, which may range from massages to yoga, a warm bath to mental visualization driven by deep breathing techniques to acupuncture. But also listening to favorite music, a swim or a walk in nature can lead to significant improvements in the level of tension.

When these countermeasures are insufficient and the state of alert is also associated with sleep disorders, you can find a bland additional aid in some active principles of natural origin able to positively influence the functionality of neural circuits that control stress reactions. The linden or camomile teas, herbal teas of mauve, escolzia or valerian, the hawthorn or passion flower extracts and mixtures of all the plants mentioned are the "green" remedies most proven and harmless to ease tension and promote sleep. If you choose to use them, however, better to opt for certified preparations sold in pharmacies, and tell your doctor before you start using them, especially if you are already using drugs against anxiety, or for the treatment of other pathologies, during pregnancy and lactation or whether to need is a baby.

Drug therapy

When the doctor feels that to counter this form of anxiety is necessary to resort to drugs, contrary to what one might think, the most useful active ingredients do not belong to the class of tranquilizers, but to that of antidepressants , particularly the SSRIs (inhibitors of serotonin reabsorption system). SSRIs are well tolerated drugs and, as a rule, do not cause significant side effects, but to obtain the maximum benefits are to be used carefully following the instructions of the physician with respect to dosages and timing of recruitment.

To observe an improvement in anxiety symptoms it is necessary to have a little 'patience because the anxiolytic effect of SSRIs is not immediate, but it appears on average after 2-4 weeks from initiation. Got the benefit, then the treatment should not be interrupted as long as the doctor considers it appropriate. Generally, this happens after a few weeks or months. To avoid effects rebound (i.e. exacerbation of anxiety symptoms), the abandonment of the drugs should always be done gradually, with progressive reductions in the amount taken, and be monitored by your doctor.

In the small proportion of patients in whom the disorder the anxiety is so intense as to deserve a pharmacological intervention by the immediate tranquilizing effects, your doctor may prescribe compounds of the class of benzodiazepines , taken for no longer than 2-3 weeks with SSRIs, waiting to manifest fully the action of the latter . Benzodiazepine drugs are delicate to handle, since associated with a number of side effects and contraindications, as well as the ability to induce tolerance and physical and psychological dependence. To avoid a worsening of anxiety, the discontinuation of benzodiazepine should be gradual, with progressive dose reduction.

Psychotherapeutic approach

The drugs are very helpful to alleviate the acute manifestations of anxiety disorder and promote the overcoming, but to solve the problem long term you must also perform a processing and adaptation work to the anxiety-provoking stimulus, using a psychological support. In this context, the technique that has been shown to be able to determine the greatest benefits is the behavioral therapy aimed at "deconditioning from anxiety-provoking stimulus", ie to loosen the bond between the critical situation and the patient's anxious reaction.

This strategy envisages that the anxious person, rather than avoid them, you gradually expose the events considered stressful, analyze them with the help of an expert and process them in a positive light to indent the experience in a normal context and deal with it better on subsequent occasions. The behavioral therapy is very useful also in the case of "anticipatory" anxiety: a form of anxiety that occurs before exposure to a stimulus known to be disturbing and which is often induced from having lived highly traumatic experiences in similar situations previously.

Support interventions

Ø  Receive regular rhythms of life.

Ø  Sleeping a sufficient number of hours each night.

Ø  Making healthy food choices.

Ø  Practicing moderate physical activity every day.

Ø  Avoid excessive working stress and carve out small breaks to relax during the day.

Ø  Take all therapies prescribed by a doctor regularly, to the indicated dose.

Ø  Avoid drinking alcohol and drinks with caffeine.

Ø  No smoking or try to reduce the number of regular cigarettes.

Ø  Attend groups of self-help and share its experience with other people with a similar problem.